▸ Hospital · HI · CCN 120026
PALI MOMI MEDICAL CENTER
98-1079 MOANALUA ROAD, AIEA, HI, 96701-
118 bedsAcute Care Hospitals2
Compliance grade
C
77/100
Procedures tracked
43
of 209 target codes
Payers
11
with negotiated rates
Rates published
1,848
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 11 | — | — | $1,230 | $14,303 | $35,524 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 6 | — | — | $1,230 | $5,525 | $19,925 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 6 | — | — | $1,230 | $5,525 | $10,150 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 6 | — | — | $1,230 | $5,525 | $6,966.59 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $1,230 | $16,373 | $47,643 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $1,230 | $11,436 | $28,320 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $1,230 | $8,796.49 | $21,724 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $1,230 | $6,676.73 | $20,900 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $1,230 | $8,405.35 | $26,895 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $1,230 | $6,431.64 | $21,409 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $1,230 | $16,622 | $40,689 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $1,230 | $9,423.71 | $32,708 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $1,230 | $7,456.01 | $28,643 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $1,230 | $13,255 | $32,708 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $1,230 | $8,817.5 | $32,239 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $1,230 | $5,691.37 | $32,239 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $1,230 | $12,266 | $30,719 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $1,230 | $7,598.06 | $22,403 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $1,230 | $5,799.41 | $17,170 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $1,230 | $10,065 | $25,155 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $1,230 | $6,571.69 | $18,515 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $1,230 | $8,008.2 | $20,144 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $1,230 | $13,786 | $39,782 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $1,230 | $11,910 | $29,630 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $1,230 | $8,231.28 | $20,889 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $1,230 | $19,830 | $49,121 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $1,230 | $10,516 | $46,126 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $1,740 | $46,138 | $115,254 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $1,740 | $23,848 | $73,737 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $1,740 | $16,718 | $42,653 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $1,740 | $16,792 | $42,869 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $1,740 | $13,383 | $34,751 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $1,740 | $35,510 | $85,617 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $1,740 | $32,901 | $76,300 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $1,740 | $19,064 | $48,783 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $1,740 | $29,623 | $73,287 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $1,740 | $20,959 | $54,862 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $1,740 | $16,072 | $41,359 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $1,740 | $27,477 | $72,667 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $1,740 | $16,178 | $58,475 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $1,740 | $14,826 | $58,220 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $1,740 | $12,194 | $31,634 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $1,740 | $19,749 | $51,778 |
Payer mix (top 11)
| Payer | Codes covered | Median rate |
|---|---|---|
| verdegard | 43 | $4,430 |
| mdx | 43 | $11,827 |
| UnitedHealthcare | 43 | $1,230 |
| alohacare | 40 | $13,319 |
| devoted | 40 | $13,985 |
| hmsa | 40 | $19,790 |
| ohana | 40 | $13,852 |
| Kaiser Permanente | 40 | $33,730 |
| pac admin | 27 | $5,525 |
| hwmg/hmaa | 27 | $6,305 |
| uha | 27 | $5,603 |